From the Department of Anaesthesia, Galway University Hospitals and National University of Ireland, Galway, Ireland (C.K., J.G.L.); Department of Anesthesia, Keenan Research Centre for Biomedical Sciences, St. Michael’s Hospital, Toronto, Ontario, Canada (M.J., J.G.L.); and Departments of Anesthesia, Physiology, and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada (J.G.L.).

Submitted for publication March 28, 2017. Accepted for publication August 8, 2017.

Submitted for publication March 28, 2017. Accepted for publication August 8, 2017.×

Research Support: Supported by an operating grant from the Canadian Institutes for Health Research (Ottawa, Ontario, Canada), by the Science Foundation Ireland (16/FRL/3845; Dublin, Ireland), and by the Keenan Research Center for Biomedical Sciences at St. Michael’s Hospital (Toronto, Ontario, Canada).

Research Support: Supported by an operating grant from the Canadian Institutes for Health Research (Ottawa, Ontario, Canada), by the Science Foundation Ireland (16/FRL/3845; Dublin, Ireland), and by the Keenan Research Center for Biomedical Sciences at St. Michael’s Hospital (Toronto, Ontario, Canada).×

Correspondence: Address correspondence to Dr. Laffey: Department of Anaesthesia, School of Medicine, Clinical Sciences Institute, National University of Ireland Galway, Galway, Ireland. john.laffey@nuigalway.ie. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.

Article Information

Review Article/Critical Care

Review Article | September 2017

Stem Cell–based Therapies for Sepsis

Anesthesiology Newly Published on September 7, 2017. doi:10.1097/ALN.0000000000001882

Anesthesiology Newly Published on September 7, 2017. doi:10.1097/ALN.0000000000001882

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Sepsis is a life-threatening syndrome resulting in shock and organ dysfunction stemming from a microbial infection. Sepsis has a mortality of 40% and is implicated in half of all in-hospital deaths. The host immune response to microbial infection is critical, with early-phase sepsis characterized by a hyperinflammatory immune response, whereas the later phase of sepsis is often complicated by suppression. Sepsis has no treatment, and management remains supportive.

Stem cells constitute exciting potential therapeutic agents for sepsis. In this review, we examine the rationale for stem cells in sepsis, focusing on mesenchymal stem/stromal cells, which currently demonstrate the greatest therapeutic promise. We examine the preclinical evidence base and evaluate potential mechanisms of action of these cells that are important in the setting of sepsis. We discuss early-phase clinical trials and critically appraise translational barriers to the use of mesenchymal stem/stromal cells in patients with sepsis.